ActiveIn good standing

providence medical foundation

Foreign Nonprofit Corporation · Entity Number E32136422023-6 · NV Business ID NV20232795815

Formed: May 23, 2023
Annual List: Due by May 31, 2027
Managed by: Not on file

Record

Entity Number: E32136422023-6
NV Business ID: NV20232795815
Entity type: Foreign Nonprofit Corporation
Home jurisdiction: California
Formed: May 23, 2023
Record as of: September 17, 2026

Registered agent

C T CORPORATION SYSTEM**· 500+ entities

701 S CARSON ST STE 200 · Carson City, NV 89701· 500+ entities

Principal office

Not on file

Mailing address

Not on file

Officers, managers, and members

Name	Role	Address
Katherine Broderick	Secretary	200 W. Center Street Promenade, Suite 800 · Anaheim, CA 92801
Katie Gonzalez· 2 entities	Treasurer	200 W. Center Street Promenade, Suite 800 · Anaheim, CA 92801
Jill Duplechan· 3 entities	President	200 W. Center Street Promenade, Suite 800 · Anaheim, CA 92801
Susan Huang· 5 entities	Director	200 W. Center Street Promenade, Suite 800 · Anaheim, CA 92801
Jill Duplechan· 3 entities	Director	200 W. Center Street Promenade, Suite 800 · Anaheim, CA 92801
James Benoit, M.D.· 2 entities	Director	200 W. Center Street Promenade, Suite 800 · Anaheim, CA 92801
Niki Balginy· 2 entities	Director	200 W. Center Street Promenade, Suite 800 · Anaheim, CA 92801
Nikhraj Brar, M.D.· 2 entities	Director	200 W. Center Street Promenade, Suite 800 · Anaheim, CA 92801
Laureen Driscoll· 2 entities	Director	200 W. Center Street Promenade, Suite 800 · Anaheim, CA 92801
Matt Ho· 2 entities	Director	200 W. Center Street Promenade, Suite 800 · Anaheim, CA 92801
Sandra Mathur, M.D.· 2 entities	Director	200 W. Center Street Promenade, Suite 800 · Anaheim, CA 92801
Beth Nunn· 2 entities	Director	200 W. Center Street Promenade, Suite 800 · Anaheim, CA 92801
Nan Onest· 2 entities	Director	200 W. Center Street Promenade, Suite 800 · Anaheim, CA 92801
Elizabeth Sander Difiori	Director	200 W. Center Street Promenade, Suite 800 · Anaheim, CA 92801
Jerome Wang, M.D.· 2 entities	Director	200 W. Center Street Promenade, Suite 800 · Anaheim, CA 92801
Antonio Ferrey· 3 entities	Director	200 W. Center Street Promenade, Suite 800 · Anaheim, CA 92801
Bob Just· 2 entities	Director	200 W. Center Street Promenade, Suite 800 · Anaheim, CA 92801
Raul Marquez, MD· 2 entities	Director	200 W. Center Street Promenade, Suite 800 · Anaheim, CA 92801
Mark Pardoe· 2 entities	Director	200 W. Center Street Promenade, Suite 800 · Anaheim, CA 92801
Roscoe Marter· 2 entities	Director	200 W. Center Street Promenade, Suite 800 · Anaheim, CA 92801
Keith Marton, MD· 2 entities	Director	200 W. Center Street Promenade, Suite 800 · Anaheim, CA 92801
David Mast· 3 entities	Director	200 W. Center Street Promenade, Suite 800 · Anaheim, CA 92801
Michael Sugarman, MD· 2 entities	Director	200 W. Center Street Promenade, Suite 800 · Anaheim, CA 92801
Darryl Elmouchi, M.D· 2 entities	Director	200 W. Center Street Promenade, Suite 800 · Anaheim, CA 92801

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